Breast Health

Hispanic Women Discover Own Breast Cancer, But Wait

Most breast cancers in Hispanic women are detected by the women themselves, a new study shows. This is despite high rates of screening mammography in this population.

What is troubling, however, is that about half of all women who noticed an abnormality waited at least a month before seeking medical help, according to new research presented at the American Association for Cancer Research Conference on the Science of Cancer Health Disparities.

Two-thirds of breast cancers in Hispanic women are discovered by accident, while only 23 percent are detected through mammography; another 6 percent are found during a clinical exam.

Yet screening mammography rates were 83 percent among US-born Hispanic women and 62 percent among non-US-born Hispanic women, say researchers from The University of Arizona College of Public Health.

Why did women wait so long before seeking help? Study author Rachel Zenuk says it is due largely to the lack of health insurance or inability to afford medical care.

Hispanic Breast Cancer Needs Study

The study is one of several studies being presented at the conference that examines breast cancer issues among Hispanic women.

According to Dr. Elena Martinez, co-leader of the Cancer Prevention and Control Program at the Arizona Cancer Center, "The problem [of breast cancer] is very poorly understood in this population, and it's an issue that affects the U.S. because of the large and growing population of Hispanics in this country."

Two of these studies, including the one noted above, rely on data from the ELLA Binational Breast Cancer Study which, so far, has recruited over 650 women; about half are Mexican-American women in the US and half in Mexico.

So far the study has determined that women in Mexico tend to be diagnosed at an older age than women in the US, although many risk factors were similar.

Family History and "Triple-Negative" Linked

The second study to use ELLA data found that Hispanic women with a family history of breast cancer were more likely to have triple-negative breast cancer, although the same did not hold true for African-American women with a family history of the disease.

This type of tumor is estrogen-receptor-negative, progesterone-receptor-negative, and HER2neu-receptor-negative and calls for different treatment options than other breast cancer types.

But the increased risk among Hispanic women applied to those born in Mexico, not among those born in the US.

A third group of researchers found that Hispanic women born in the US were more likely to have a number of risk factors for breast cancer, including a family history of the disease and obesity.

Lifestyle factors could explain much of this difference, say researchers, though not all of it.

Always consult your physician for more information.

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May 2009

Breast Cancer Testing

It is important to remember that a lump or other changes in the breast, or an abnormal area on a mammogram, may be caused by cancer or by other, less serious problems.

To determine the cause of any signs or symptoms, your physician will perform a careful physical exam that includes a personal and family medical history as well as determining current overall health status.

In addition, an examination may include the following:

palpation- carefully feeling the lump and the tissue around it - its size, its texture, and whether it moves easily. Benign lumps often feel different from cancerous ones.

nipple discharge examination - fluid may be collected from spontaneous nipple discharge and then sent to the lab to look for cancer cells. Most nipple secretions are not due to cancer. An injury, infection, or benign tumor may cause discharge.

For women who are at high risk for breast cancer, a procedure called ductal lavage may be used. Cells are collected from inside the milk ductal system - the location where most breast cancers begin.

In addition to a physical examination by your physician, an imaging test will be performed.

Imaging tests may include one or more of the following:

digital mammography (Also called full-field digital mammography, or FFDM) - a diagnostic mammogram using solid-state detectors instead of x-rays to diagnose unusual breast changes, such as a lump, pain, nipple thickening or discharge, or a change in breast size or shape.

A diagnostic mammogram is also used to evaluate abnormalities detected on a screening mammogram. It is a basic medical tool and is appropriate in the workup of breast changes, regardless of a woman's age.

Some studies have found FFDM to be more accurate in finding cancers in women younger than 50. Also, it has been found that women undergoing digital mammography do not have to return for additional studies as often as with standard film mammography because the digital images have fewer questionable spots needing more investigation.

However, not all hospitals and mammography facilities have digital equipment available.

ultrasonography - a procedure that uses high-frequency sound waves, not heard by humans. The sound waves enter the breast and bounce back. The pattern of their echoes produces a picture called a sonogram, which is displayed on a screen. This exam is often used along with mammography.

scintimammography- a specialized breast scan that uses a tiny amount of radioactive substance to assess the breasts.

The radioactive substance, called a radionuclide (radiopharmaceutical or radioactive tracer), is injected and absorbed by certain types of body tissues. Images are taken of the breasts and analyzed.

magnetic resonance imaging (MRI) - a diagnostic procedure that uses a combination of large magnets, radiofrequencies, and a computer to produce detailed images of organs and structures within the body.

In early 2007, the American Cancer Society (ACS)recommended new guidelines which include screening MRI with mammography for certain high-risk women.

According to the ACS, contrast-enhanced MRI of the breasts has been shown to have a high sensitivity for detecting breast cancer in women either with or without symptoms.

A physician may need to remove fluid or tissue from the breast to be sent to the lab to look for cancer cells. The procedure, known as a breast biopsy, may be performed using a needle to acquire the tissue sample or by a surgical method.